Lower Starting Dose of Remicade Proves Effective in Treating Psoriatic Arthritis

A study published in the journal Rheumatology reported that a lower than recommended starting dose of Remicade (infliximab) followed by gradual escalation of dose was effective in treating psoriatic arthritis patients.

Psoriatic arthritis is a condition that stems from psoriasis, an autoimmune disease in which the body’s immune system attacks the skin, resulting in scaly, red patches on the skin. In some psoriasis patients, the immune system attacks the joints as well, leading to inflammation and the condition known as psoriatic arthritis. Symptoms of psoriatic arthritis are highly variable among patients, coming and going over time and affecting one or many joints of the body.

The study conducted at the Copenhagen Center for Arthritis Research looked at 462 Danish and Icelandic psoriatic arthritis patients who were given initial doses of Remicade that were well below the recommended amounts (approximately 60%). The lower doses were maintained in the majority of patients for more than 12 months.

Researchers found that time until dose escalation, response rates of the treatment, drug survival and disease activity after 12 months was not affected by the starting dose of Remicade.

A common strategy in treating rheumatoid arthritis is to start with a lower than normal dose of Remicade and to increase dosing levels gradually. The researchers in this study concluded that a similar approach was effective in treating psoriatic arthritis.

Reference: Glintborg, Bente, et al. Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis: results from the nationwide registries DANBIO and ICEBIO. Rheumatology 2014 June 17 [doi:10.1093/rheumatology/keu252].